Health Worker Factors Associated With Prescribing of Artemisinin Combination Therapy for Uncomplicated Malaria in Rural Tanzania

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dc.contributor.authorSelemani, Majige
dc.contributor.authorMasanja, Irene M.
dc.contributor.authorDan, Kajungu
dc.contributor.authorAmuri, Mbaraka
dc.contributor.authorNjozi, Mustafa
dc.contributor.authorKhatib, Rashid A.
dc.contributor.authorAbdulla, Salim
dc.contributor.authorDe Savigny, Don
dc.date.accessioned2016-07-08T12:11:59Z
dc.date.available2016-07-08T12:11:59Z
dc.date.issued2013-09
dc.description.abstractImproving malaria case management is partially dependent on health worker compliance with clinical guidelines. This study assessed health worker factors associated with correct anti-malarial prescribing practices at two sites in rural Tanzania. Repeated cross-sectional health facility surveys were conducted during high and low malaria transmission seasons in 2010 and collected information on patient consultations and health worker characteristics. Using logistic regression, the study assessed health worker factors associated with correct prescription for uncomplicated malaria defined as prescription of artemisinin-based combination therapy (ACT) for patients with fever and Plasmodium falciparum asexual infection based on blood slide or malaria rapid diagnostic test (RDT) according to national treatment guidelines. The analysis included 685 patients with uncomplicated malaria who were seen in a health facility with ACT in stock, and 71 health workers practicing in 30 health facilities. Overall, 58% of malaria patients were correctly treated with ACT. Health workers with three or more years' work experience were significantly more likely than others to prescribe correctly (adjusted odds ratio (aOR) 2.9; 95% confidence interval (CI) 1.2-7.1; p = 0.019). Clinical officers (aOR 2.2; 95% CI 1.1-4.5; p = 0.037), and nurse aide or lower cadre (aOR 3.1; 95% CI 1.3-7.1; p = 0.009) were more likely to correctly prescribe ACT than medical officers. Training on ACT use, supervision visits, and availability of job aids were not significantly associated with correct prescription. Years of working experience and health worker cadre were associated with correct ACT prescription for uncomplicated malaria. Targeted interventions to improve health worker performance are needed to improve overall malaria case management.en_US
dc.identifier.citationSelemani, M., Masanja, I.M., Kajungu, D., Amuri, M., Njozi, M., Khatib, R.A., Abdulla, S. and de Savigny, D., 2013. Health worker factors associated with prescribing of artemisinin combination therapy for uncomplicated malaria in rural Tanzania. Malaria journal, 12(1), p.1.en_US
dc.identifier.doi10.1186/1475-2875-12-334 · Source: PubMed
dc.identifier.urihttp://hdl.handle.net/20.500.11810/2885
dc.language.isoenen_US
dc.subjectUncomplicated malariaen_US
dc.subjectCorrect prescriptionen_US
dc.subjectArtemisinin combination therapyen_US
dc.titleHealth Worker Factors Associated With Prescribing of Artemisinin Combination Therapy for Uncomplicated Malaria in Rural Tanzaniaen_US
dc.typeJournal Article, Peer Revieweden_US
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